Agenda item

Report of the Borough Lead, North West London - Integrated Care Board

The Better Care Fund (BCF) Quarter two update was presented by the Borough Lead for NWL ICB.  The update, jointly prepared by the local authority and ICP colleagues, was submitted to NHS England.

The Quarter 2 update covered finances, capacity and demand, and key indicator metrics, with a more comprehensive report due at the financial year's end.

·                 The total value of BCF services was approximately £33 million, with 47.7% of funds spent by the end of Quarter 2.  Delays were due to additional discharge funding received mid-year, which the local authority utilised for services supporting hospital discharge, such as temporary residential care and home care.

·                 Spending was expected to align by year-end, with no immediate concerns raised.

·                 All initiatives planned with winter in mind were confirmed to be in place.  Anticipated winter pressures were acknowledged, but the Board was assured that preparations were robust.

Unplanned Hospitalisations for Chronic Ambulatory Care-Sensitive Conditions:  There were inaccuracies in national data indicating overperformance.  Harrow Borough Partnership developed an admission avoidance strategy and prioritised reducing ambulatory care-sensitive (ACS) conditions through integrated neighbourhood teams, virtual wards, and monitoring programs.  A data accuracy review was underway by NHS England.

Discharge to Normal Place of Residence:  The target was 95.9%, with a current achievement of 94.9%.  Complex cases, especially those with social and housing needs, impacted this metric.  Additional discharge funding aimed to improve this indicator by supporting reablement efforts, allowing patients to return home when possible.

Emergency Admissions for Falls in Individuals Over 65:  National data inaccurately suggested strong performance.  The Board had implemented an integrated falls service, with ongoing efforts to improve outcomes despite unreliable data.

Admissions to Permanent Residential Care: This indicator was assessed annually. Various initiatives and additional funding were being applied to minimise admissions to permanent care.

Following the presentation, the board discussed the challenges with the accuracy and timeliness of data.  Key points included:

The Chair expressed disappointment over the unreliable data, though she commended the effort put into the update.  The Board raised concerns about the quarterly data collection and processing delays, noting that in a commercial setting, timely data collection is standard and suggesting that the BCF adopt a more rigorous approach.  The Assistant Director of Integration and Delivery clarified that data collection was conducted by local hospitals and providers, and then submitted centrally.  Issues had arisen during the central processing phase, not at the local collection level.  If necessary, the Board would consider using locally sourced data to provide a more accurate report for the next quarter.

The Board agreed to treat data accuracy and processing as a separate issue to be monitored.  They expressed gratitude for the transparency provided on this matter.  The Director for Public Health noted frustrations with delayed confirmation of discharge funding, which often depended on Treasury processes and impacted planning.  The Director observed that this issue was widely recognised and that incremental improvements had been made.

The Chair suggested the Board support efforts to ensure data reliability, proposing action if needed to assist in securing accurate and timely data.

RESOLVED:  The Board noted the report and acknowledged the challenges with data collection and processing.